Bone-aligning instrument



May 23, 1961 s, JONAS ETAL 2,985,168

BONE-ALIGNING INSTRUMENT Filed March 19, 1959 BQNE-ALIGNING INSTRUMENTSalo Jonas, 405 Whalley Ave., and Albert M. Jonas, 389 Norton Parkway,both of New Haven, Conn.

Filed Mar. 19, 1959, Ser. No. 800,484

2 Claims. (Cl. 128-83) This invention relates to an instrument foraligning broken bones, particularly where there is overriding ordisplacement of the bone fragments necessitating an open reduction ofthe fracture.

Where a bone has been completely fractured and the fragments have beendisplaced and perhaps override or overlap each other at their adjacentends, it is necessary to perform an open reduction of the fracture inorder that the bone fragments may be properly aligned and in most casesheld together by the use of a medullary pin. In our United States PatentNo. 2,672,861, issued March 23, 1954, we have illustrated a medullarysplint or pin which may be introduced into the bone fragments at thepoint of fracture, thus requiring an incision only at this point. In theuse of this splint or for that matter any other splint, it is sometimesdifiicult to quickly bring the two adjacent ends of the bone fragmentsinto apposition. It is contemplated by the present invention to providean instrument which may be employed through the incision at the point offracture to assist in bringing the ends of the bone fragments intoalignment quickly and expediently so as to not only insure the properpositioning of the bones, but also to enable their proper alignment tobe effected with the expenditure of much less time than is ordinarilyinvolved in such an operation and without any damage to surroundingmuscles as the bonealigning instrument is applied directly on the endsof the fractured bones without any impingement on soft tissue. While theinstrument presently illustrated is particularly useful with themedullary extension splint shown in our patent to which reference hasbeen made above, it will be understood that it is not limited to thisuse.

One object of the present invention is to provide a new and improvedinstrument for aligning the fragments of a fractured bone.

Still another object of the invention is to provide an instrument ofthis character of simple and relatively inexpensive construction whichwill nevertheless be efficient and positive in operation and by whichboth bone fragments may be engaged and readily moved into properalignment.

A still further object of the invention is to provide an instrument foraligning the fragments of a fractured bone wherein a Jonas extensionmedullary splint is employed, the instrument having means for engagingthe point of the pin when inserted into one of the fragments and alsohaving means to engage the other bone fragment so as to properly alignthe two and permit the projection of the pin into the second fragment.

To these and other ends the invention consists in the novel features andcombinations of parts to be hereinafter described and claimed.

In the accompanying drawings:

Fig. 1 is a bottom plan view of a bone-aligning instrument embodying ourinvention;

Fig. 2 is a top plan view thereof;

Fig. 3 is a sectional view on line 3-3 of Fig. 2;

Fig, 4 is a sectional view on line 44 of Fig. 3;

ice

Fig. 5 is a sectional view of a malaligned fractured bone showing theuse of the instrument;

Fig. 5 is a sectional view on line 5 5 of Fig. 5 showing the engagementof the medullary pin and one of the bone fragments by the instrument atthe beginning of the operation of bringing the bone fragments intoalignment; and

Fig. 6 is a sectional View showing the bone after alignment has beeneffected and the medullary pin extended.

As illustrated the instrument comprises a hollow tubular memberdesignated by the numeral 10 which, as illustrated in Fig. 4, is ofhollow rectangular form in cross section although not limited to thisparticular shape. Over most of its length the instrument comprises upperand lower members 11 and 12 and side members 13 and 14. .As shown inFigs. 1 to 3, the upper member 11 is extended beyond the lower member 12so as to expose the underside of the former for a short distance sothat, as will be hereinafter explained, one of the bone fragments may bereceived within the instrument, the end of the fragment bearing againstthe under or inner side of the top wall 11.

At its extreme end this upper Wall is provided with a substantiallyV-shaped recess 15 opening outwardly and having rounded corners 16 atits outer end. The side walls 13 and 14 are coextensive in length withthe upper wall at this end of the instrument to provide side flanges butmay be beveled, as shown at 17, adjacent their ends. Thus at the end ofthe instrument an open channel-shaped portion is provided by the wall 11and the flanges formed by the side walls 13 and 14.

Also the lower or bottom wall 12 is provided with a V-shaped recess orslot 18 similar to the recess 15 and opening in the same direction asthe latter, the sides of this slot also being provided with roundedcorners 19, the rounded corners being provided so that there will be nosharp corners or points to injure the bone fragments when the instrumentis used.

At its opposite end the instrument may be similarly formed except thatin this case the bottom wall 12 is extended beyond the upper wall 11 andthe side walls are coextensive with the bottom wall and are providedwith beveled end portions 17 Likewise at this end of the instrumentV-shaped recesses 15 and 18 are provdied in the upper and lower wallsrespectively, these recesses being formed similarly to the recesses 15and 18 previously described and provided with rounded corners 16 and 19at their outer ends. It will be noted, however, that the recesses atthis end of the tool may be slightly narrower than those previouslydescribed and also that the difference in length between the top andbottom walls of the tool is less than that at the other end. Thediiference in size between the formations at the two ends of theinstrument enables the instrument to be used with bones of differentsizes and where different conditions are encountered.

In Figs. 5; 5 and 6 of the drawings there is illustrated the use of theinstrument in the open reduction of a bone fracture where there isconsiderable misalignment of the two bone fragments as well as someoverlapping thereof. In this instance the Jonas medullary splint isemployed. The upper bone fragment 20 has been reamed out and the splintinserted therein. This splint includes an outer sleeve member 21, a pin22 slidably mounted therein, and a spring 23 above the pin and urging itdownwardly. The pin is held in its retracted position as illustrated bya cotter pin 24 inserted through registering openings in the pin 22 andsleeve member 21. The lower bone fragment 25 has also been reamed out,as shown at 25*, for the reception of the pin 22 after the fragmentshave been aligned.

With the parts in the position shown in Fig. 5, the

3 splint has been inserted into the upper fragment and the instrument isinserted between the bone fragments as shown. The lower end of the pin22 is tapered, as shown at 26, and this tapered end of the pin isengaged in the inner end of the recess so that the bone fragment will beheld against lateral movement with respect to the instrument 10. Theupper end of the lower bone fragment is received between the side walls13 and 14 of the instrument, as shown, and engaged to some extent in theouter end of the recess 18.

With the parts in this position the outer end of the instrument is swungdownwardly in the direction of the arrow 27 while at the same time theforefinger of the surgeon may embrace the lower end of the bone fragment20 and hold the tapered end of the pin 22 in place within the recess 15.Moving the outer free end of the instrument downwardly in this mannerexerts an upward pressure on the upper fragment 2% and a downwardpressure on the lower fragment 25 to bring the two into a position inwhich the ends do not overlap. Then by pressure of the surgeons thumb onthe bone fragment 25 in the direction of the arrow 28, the two fragmentsmay be properly aligned.

During this operation it will be seen that the upper bone fragment isprevented from moving away from the tool by the end 26 of the pin 22engaging in the recess 15 and by the engagement of the upper end of thefragment 25 in the channel of the instrument between the side walls 13and 14 and the outer end of the recess 18. By this arrangement the bonefragments cannot slip away from the instrument but will be accuratelyheld by it and brought into alignment.

When the two bone fragments have been alignedand before the instrumentis removed from position, the cotter pin 24 may be Withdrawn from theregistering openings in the pin 22 and sleeve member 21, and the pin 22will then be projected by the spring 23 into the reamed opening 25 inthe lower fragment. The instrument 19 may then be withdrawn by amovement in the direction of its length and the reduction will becompleted, as shown in Fig. 6.

It will be understood that the other end of the instrument may beemployed in exactly the same manner, the particular end which is useddepending upon the size of the fractured bone or other conditions.

It will be apparent that the construction at each end of the toolprovides an extended surface of the upper or the lower walls to supportone of the bone fragments, which surface is provided with the V-shapedrecess 15 or 15 to permit the projection therethrough of the pin 22 ifthe Jonas splint is employed. The lower surface of this extension restsupon the end of the other bone fragment and receives this end in thechannel formed by one of the walls 11 or 12 as the case may be and theside flanges extending therefrom. The edges of the slots 18 or 15*provide stop means for the lower bone fragment to hold it in positionduring the aligning operation, this stop means being at the inner end ofthe channel-shaped portion provided by the side walls 13 and 14 and oneof the walls 11 or 12.

While, as illustrated, the body of the instrument is hollow, tubular andof substantially rectangular form in cross section, this may be variedas desired. For example, the body portion of the instrument may be ofellipsoidal form in cross section, if desired, or may consist of a roundor cylindrical tubular member. -In the latter case the end portionswould be cut off at an agle to the axis of the tube so as to provide abone-supporting portion projecting beyond the end of the closed tubularportion. In this event the walls of the tubular portion so cut wouldprovide the flanges formed by the side walls 13 and 14 of therectangular tubular body illustrated.

Also it will be obvious that the body of the instrument may be a plainflat solid member of any desired thickness, the ends of which will beformed as shown in the drawing and described in the accompanying claims.That is to say, it is the ends of the instrument which are the partsemployed in the use of the tool and the intermediate or body portionserves as a handle, and this portion may be hollow or solid as desired.

While we have shown and described a preferred embodiment of ourinvention, it will be understood that it is not to be limited to all ofthe details shown, but is capable of modification and variation withinthe spirit of the invention and within the scope of the claims.

What we claim is:

1. An aligning instrument for use in the open reduction of a bonefracture comprising an elongated tubular body member having upper andlower walls and opposite side walls, one of the upper or lower wallsextending beyond the other to provide upon its outer face a supportingsurface for a fragment of the fractured bone and to provide at its innerside together with said side walls an open channel-shaped portion toreceive the other bone fragment, and each of said upper and lower wallshaving an outwardly opening substantially V-shaped recess therein, saidrecesses being ofiset in a direction longitudinally of the instrument.

2. An aligning instrument for use in the open reduction of a bonefracture comprising an elongated tubular body member having upperand'lower walls and opposite side walls, one of the upper or lower wallsextending beyond the other to provide upon its outer face a supportingsurface for a fragment of the fractured bone and to provide at its innerside together with said side walls an open channel-shaped portion toreceive the other bone fragment, each of said upper and lower wallshaving an outwardly opening substantially V-shaped recess therein, saidrecesses being offset in a direction longitudinally of the instrument,and the other end of said instrument being similarly formed with theprojection of the extended wall beyond the opposite wall being of lesslength than at said first end portion.

References Cited in the file of this patent UNITED STATES PATENTS1,920,821 Wassenaar Aug. 1, 1933 2,695,607 Hipps et al Nov. 30, 19542,753,150 Gibson July 3, 1956 OTHER REFERENCES Journal of Bone and JointSurgery, vol. 13, 1931, pages 378-379 relied on. (Copy in Div. 55.)

